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82 Cards in this Set
- Front
- Back
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Biological Perspective |
Mental illness is caused by abnormal neurochemistry, neuroanatomy, or hormonal imbalance |
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Cognitive Perspective |
Humans are rational; abnormality results when rationality is lost |
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Psychotic Disorders |
Psychosis: loss of contact with reality - all psychotic disorders involve delusions, hallucinations, disorganized speech, disorganized behavior, and/or negative symptoms - DSM IV- used subtype scale - DSM 5- uses severity specifier |
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Rates of Schizophrenia |
- 0.3-0.7% worldwide - similar across cultures - symptoms emerge gradually, in late teens- mid-thirties; emerge earlier in boys - boys have more negative symptoms - same rate of prevalence in genders |
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Risk Factors in Schizophrenia |
- 3% in divorced people - 2% in singles - 1% in married - lower socioeconomic status= greater risk - closer relative with schizophrenia= greater risk - 5-6% of schizophrenics commit suicide - 20% attempt suicide/have suicidal thoughts - drugs make symptoms worse
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Delusions |
- positive symptoms - fixed beliefs that don't change despite conflicting evidence - person realizes others think their delusions are irrational but they themselves still believe them - may be bizarre or not bizarre - 0.2% of people have delusional disorder - usually lifelong diagnosis |
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Persecutory Delusions |
Belief that someone is out to get you |
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Referential Delusions |
Belief that certain environmental cues are meant just for you |
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Grandiose Delusions |
Belief that you are a highly gifted or exceptional person; often related to religion |
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Erotomanic Delusions |
Belief that someone (often someone important) is in love with you, ex. boss, famous person |
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Nihilistic Delusions |
Belief that some catastrophe will cause the world to end/ the world already has ended |
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Somatic Delusions |
Preoccupation with health, ex. delusions about body odor, parasitic infections, seeing body as misshapen |
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Jealous Delusions |
Belief that partner is being unfaithful Only applies if partner is not unfaithful More common in men |
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Thought Withdrawal Delusions |
Belief that someone is taking thoughts out of your head |
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Thought Insertion Delusions |
Belief that someone is putting thoughts in your head |
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Control Delusions |
Belief that body/behaviors are being controlled by some external force |
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Hallucinations |
- positive symptom - perception-like experiences that occur without external stimuli - involuntary, vivid, usually troubling - made worse by stress, too little sleep, and drugs - some know hallucinations aren't real, some don't, some can't tell |
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'Normal' Hallucinations |
Hypnagogic: while falling asleep Hypnopompic: while waking up Religion- or culture- related |
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Auditory Hallucinations |
- experienced by 70% of schizophrenics - hearing voices that aren't their own; usually recognizable - more common in women -often derogatory commentary on person's behaviors - auditory regions react during hallucinations |
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Visual Hallucinations |
- experienced by 25% of schizophrenics - seeing things that aren't there/ distorted view of things - often accompanied by auditory |
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Tactile Hallucinations |
- feeling of something happening outside your body, ex. being touched, bugs crawling on you - formication: common effect of cocaine, meth, etc. - formica= ants |
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Motor & Somatic Sensory Cortex |
- motor cortex: maps out motor control of each body part - somatic sensory cortex: maps out how sensitive each body part is - meant to work together to ignore self-generated movement - schizophrenics have deficit in self-monitoring; can't tell sensory input is self-generated |
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Disorganized Speech |
- severe enough to impair communication - person believes they're making sense Types: - loosening of associations (derailment) - poverty of content - clanging - word salad - neologisms |
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Loosening of Associations |
- aka derailment - rambling, disjointed speech - no logical flow of ideas - could be due to lack of editing; say whatever they think |
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Poverty of Content |
- person's vocab/grammar is perfect - don't communicate any ideas with their words |
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Neologisms |
- person combines words to make new ones for terms they can't remember/don't know |
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Clanging |
- pairing unrelated words that sound alike (rhyme) |
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Word Salad |
- person can't communicate ideas or use proper grammar - also a symptom of Wernicke's aphasia |
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Catatonic Behavior |
- exists on a spectrum: catatonic stupor--------------catatonic excitement - 35% of schizophrenics have catatonia; catatonic stupor most common - used to be diagnosable only within schizophrenia; now gets its own category
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Types of Catatonic Behavior |
- Catalepsy: passive induction of posture - Waxy flexibility: slight resistance to posturing - Stupor: not actively relating to environment - Negativism: no response/opposition to external stimuli - Posturing: active induction of posture - Mannerism: odd caricature of normal actions - Stereotypy: repetitive, purposeless movements - Agitation: simpler than stereotypy; not influenced by external stimuli - Echolalia: mimicking another's speech - Echopraxia: mimicking another's actions |
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Stereotypy |
- repetitive, frequent, purposeless movements - animals engage in stereotypy when stressed - drugs like amphetamine increase stereotypy; called punding |
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Negative Symptoms of Schizophrenia |
Diminished emotional capacity - blunted affect: less emotion than appropriate - flat affect: no emotion at all - inappropriate affect: emotional response doesn't match situation Avolition: decrease in motivated, goal-oriented behavior, ex. hygiene Anhedonia: inability to feel/remember pleasure Alogia: poverty of speech; doesn't speak much |
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Life Cycle of Schizophrenia |
Prodromal: stage before symptoms reach peak; looks like depression Active-phase: when symptoms are most prevalent Residual: symptoms decrease 75% of schizophrenics live with residual symptoms; 25% recover completely |
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Brief Psychotic Disorder |
- acute onset of schizophrenia symptoms - sudden onset - only positive symptoms - can't last more than a month - people remit completely - twice as likely in women - age of onset- mid-30s - mood lability: extreme mood swings |
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Postpartum Psychosis |
- rate of 'baby blues'- 80% - rate of postpartum depression- 10-30% - rate of postpartum psychosis- 1-2 of every 1000 mothers - thought to be triggered by hormonal shift in labor - looks like psychotic episode - 4% of women end up harming their child ex. Andrea Gates- killed her 5 children |
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Polygenic |
Caused by interactions of multiple genes |
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Concordance Rate |
- likelihood that one twin will have disorder if other twin has it - schizophrenia in identical twins: concordance rate- 48% |
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Mono- & Dichorionic |
Monochorionic: twins who share a single placenta; happens 75% of the time; occurs when zygote splits 4-8 days after fertilization Dichorionic: twins who have separate environments; occurs when zygote splits less than 4 days after fertilization |
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Biological Factors in Schizophrenia |
- 5-8% more likely to be born in winter; could be because second trimester occurs during flu season - second trimester: when neural migration occurs - 'schizovirus': may occur prenatally and interfere with neural development; may remain dormant in child until triggered by hormones - 40% have high levels of antibodies; means person has experienced infection - Rh incompatibility: mother and baby's blood don't match - hypoxia: lack of oxygen - paternal age increases risk |
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Structural Abnormalities |
- associated with more negative symptoms - lead to poorer social development and cognitive difficulties - most common abnormality: enlarged ventricles - ventricles: holes in brain filled with CVS; could indicate cell death or improper development - other abnormalities: less brain volume, progressive grey matter loss, neuron density
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Biochemical Abnormalities |
- neurotransmitter binding: neurotransmitters bind to receptors to excite/inhibit neurons - dopamine has lots of receptors - Dopamine hypothesis |
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Dopamine Hypothesis- Original |
- schizophrenia originally thought to be caused by too much dopamine - intro of chlorpromazine: blocks dopamine receptors; side effect: Parkinson's-like symptoms - Parkinson's caused by too little dopamine - 70s- Parkinson's treated with L-dopa; neurons use it too make dopamine - too much L-dopa caused psychotic symptoms - evidence against: chlorpromazine doesn't work on everyone; only treats positive symptoms |
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Dopamine Hypothesis- Updated |
- basal ganglia- involved in voluntary movement, motor habits, motivation, cognitive processes; made up of caudate nucleus and putamen (together striatum) and globus pallidus - nigrostriatal pathway: starts in substantia nigra (where dopamine is made), ends in dorsal striatum; 80% of dopamine; motor role in schizophrenia -mesolimbic pathway: starts in ventral tegmental area, ends in nucleus accumbens; motivation role; associated with drug addiction; positive symptoms - mesocortical pathway: starts ventrical tegmental area, ends in prefrontal cortex; negative symptoms; too little dopamine in this pathway related to schizophrenia |
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Antipsychotic Drugs as Schizophrenia Treatment |
- old drugs only decreased dopamine; treated positive symptoms, worsened negative symptoms - 'atypical' drugs target different neurotransmitters; work better |
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Stress Hormones & Dopamine Function |
HPA axis: hypothalamus->CRH->pituitary gland->ACTH->adrenal glands->cortisol - cortisol feeds back to hippocampus to release inhibitory message - study in rats: showed increase in corticosterone leads to increase in dopamine - stress triggers increased dopamine levels |
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Neurocognitive Disorders |
- formerly 'Dementia, Delirium, Amnestic, and Other Cognitive Disorders' - term 'dementia' removed from headings, not from text descriptors; offers continuity - prevalence: currently 3-9% of people worldwide - acquired during lifetime, not born with them |
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Mild Neurocognitive Disorder |
- highly criticized for pathologizing aging - deficits in: complex attention, executive functioning, learning and memory, language, perceptual-motor functioning, and social cognition |
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Delirium |
- neurocognitive equivalent of Brief Psychotic Disorder - perserverate: responding the same way over and over - develops quickly- hours to a few days; severity fluctuates throughout the day - sundowning: increased negative emotions experienced in the evening; could be related to fatigue, confusion due to darkness, or disruption in circadian rhythms - 2/3 people with neurocognitive disorders experience sundowning - can only be diagnosed if cause is known - most people pass it off as aging - prevalence: < 0.5% in children & teens, 1% in over 55, 14% in over 85 |
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Bio Stuff |
Amino acids: make up proteins Chromosomes: contain genes; tightly coiled, double-stranded DNA Gene: contain instructions for proteins (24 000) Nucleotide base: guanine, cytosine, adenine, thymine (6 billion) Polypeptide chain: string of amino acids Protein: building blocks of living matter; +50 000 Codon: 3 nucleotides that form part of genetic code
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Biological Cause of Neurological Disorders |
- faulty gene expression/risk alleles - gene is translated into amino acid sequence by mRNA; specific protein is synthesized - codons containing different amino acids sometimes code for same protein - codons can stop production of protein as well - genetic mutations: substitution, deletion, insertion |
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Major Neurocognitive Disorder |
- significant cognitive decline from previous state - impairs daily activities - not delirium; not caused by another disorder |
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Mild Neurocognitive Disorder |
- modest decline from previous state - does not impact daily activities |
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MND due to Frontotemporal Lobar Degeneration |
- group of diseases causing progressive cell death in frontal and temporal lobes - tau protein, proganulin, ubiquitin: dysfunctional proteins - behavior variants, language variants |
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Lewy Body Disease |
- build up of abnormal proteins (Lewy bodies) in brain - dysfunctional proteins: ubiquitin, mostly alpha synuclein - misshapen proteins |
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Vascular Disease |
- restricted blood flow to brain, ex. stroke - brain sends out chemicals that do more harm than good |
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Chronic Traumatic Encephalopathy |
- caused by traumatic brain injury: displacement of brain inside skull - stage 1: no symptoms; tau starts to form around brain's blood vessels - stage 2: rage, impulsivity, depression; tau builds up in frontal lobe - stage 3: confusion, memory loss; tau builds up in temporal lobe; amygdala and hippocampus are affected - stage 4: advanced dementia; tau overwhelms the brain; brain shrinks |
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Prion Diseases |
- transmissible spongiform encephalopathies - most common in humans: Creutzfeldt-Jakob disease - prions: pure protein; necessary for life - one prion becomes misshapen, infects the rest; or mutation in prion gene - long incubation periods with no symptoms - affect humans and animals, ex. mad cow |
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Parkinson's Disease |
- death of cells in substantia nigra, loss of dopamine in nigrostriatal pathway - rigidity, stooped posture, slow shuffling walk - 75% of patients develop cognitive deficits - mood symptoms, ex. depression, anxiety - more likely in men - caused by misfolded alphasynuclein |
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Huntington's Disease |
- neuron loss in basal ganglia and cortex - highly genetic - impaired executive functioning, mood/personality changes - begins with cognitive symptoms; physical symptoms occur in late stages - marker of chromosome 4; dominant allele - huntingtin protein; caused by 30+ repeats of CAG (glutamine) |
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Alzheimer's Disease |
- coined by German physician; first recorded case: Frau Auguste Deter - most common neurocognitive disorder - rates expected to rise dramatically in coming years - 25% of those over 65 - 66% of those over 85 - late-onset (sporadic)- after 65 - early-onset (familial)- middle age; highly genetic - most patients are women - must meet criteria for mild/major neurocognitive disorder - 3rd leading cause of death in elderly; 7th overall - most common cause of death: asphyxiation
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Diagnosis of Alzheimer's |
- cannot be officially diagnosed until after death - tests used to rule out other possibilities |
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Structural changes due to Alzheimer's |
- enlarged ventricles - atrophy in hippocampus - atrophy in language area - place cells (meant to aid in navigation) are affected |
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Cholinergic Hypothesis of Alzheimer's |
- acetylcholine: important in neuroplasticity, learning and memory, cortical activation - thought that too little acetylcholine was cause of Alzheimer's - not true; giving more acetylcholine doesn't cure symptoms - measure acetylcholine levels with PET scan |
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Micro-level Neurophysiology |
- senile plaques: sticky masses of misfolded beta amyloid protein that form between neurons - leads to neurofibrillary tangles - neurofibrillary tangles: tau protein meant to provide structure for microtubules (transport system of cells); tau gets misfolded, causes tangles; cells can't transport things, leads to cell death |
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Risk Factors in Alzheimer's |
early onset: - amyloid precursor protein gene late onset: - apolipoprotein E- important in removing cholesterol and beta amyloid; APOE 2- decreases risk; APOE 4- increases risk - viral/prion theory: triggers misfolding of proteins - toxin buildup in brain, ex. zinc, lead - autoimmune theory: body sees proteins as threat, attacks them |
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Anxiety |
- anxiety and fear have the same symptoms (fight or flight response); fear is in response to tangible threat; anxiety is in response to imagined/anticipated threat - 25% of people experience at least one anxiety disorder - 1/5 of sufferers seek help |
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Cognitive Psychology |
- Albert Ellis and Aaron Beck- leading cognitive psychologists - believe cognitive processes drive behaviors, thought patterns, and emotions - cognitive processes: ability to think, remember, and interpret - misinterpretation causes abnormal behaviors - changes faulty processes by questioning and re-evaluating how person normally thinks about things - 28% of pyschologists use it |
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Beck's Cognitive Model |
1. Schemas: 'file folders' containing memories, experiences, core beliefs about self, world, and future (cognitive triad); formed in childhood; triggered in adulthood; diathesis/predisposition 2. Cognitive Distortions: info processing and intermediate beliefs; attention bias; enhance negative memories 3. Automatic Thoughts: unconscious thoughts that surface; by-product of schemas; more frequent and more negative in anxiety disorders |
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Types of Cognitive Distortions |
- overgeneralization: 'if-then' thinking; one negative event viewed as never-ending pattern - all-or-none thinking: seeing world/experiences in black and white - catastrophizing: exaggerating problems - jumping to conclusions |
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Social Anxiety Disorder |
- one year prevalence: 7% - culturally-bound to NA; max 2% worldwide - more common in females - similar in all ages except lower in elderly - age of onset: 10-20 - highly comorbid - people know their anxiety is irrational - genetic component
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Counterproductive Beliefs in Social Anxiety |
- impossibly high social standards - self-criticism about performance afterwards - belief they must be perfect in every interaction - see themselves as unskilled, unattractive, inferior - always in danger of behaving incompetently |
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Selective Attention Biases in Social Anxiety |
- tend not to look people in the face - hyperaware of facial expressions related to threat - amygdala is highly active; monitors for threat - high public self-consciousness; see themselves through others' eyes |
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Treatment of Social Anxiety |
- two factors to treat: social fear and lack of social skills - social fear: cognitive restructuring, rational-emotive therapy - social skills: training programs; role playing, modeling, training groups |
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Selective Mutism |
- usually onsets before age 5 - children will engage in non-verbal social interactions - most kids grow out of it, into social anxiety disorder - prevalence: 0.03-1% |
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Separation Anxiety Disorder |
- most prevalent anxiety disorder in children - equally common in boys and girls - usually caused by loss, ex. divorce, death - 4% in children; 1.6% in teens; 0.9-1.9% in adults |
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Albert Ellis & Rational-Emotive Therapy |
- psychological problems stem from irrational beliefs and inappropriate reactions - ABCs: activating experience leads to belief system leads to consequences of belief system - treatment: dispute belief system |
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Stages of Rational-Emotive Therapy |
1. Cognitive Case Conceptualization: gathering info about patient's experiences, beliefs, triggers 2. Decatastrophizing: challenging person's fears, help them realize fears are exaggerated 3. Cognitive Restructuring: teach patient coping techniques, help them learn to reinterpret the world |
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Generalized Anxiety Disorder |
- free floating anxiety - prevalence: 4% - more common in females - age of onset: 0-20 |
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Ellis' Basic Irrational Assumptions |
- must be loved/approved of by everyone in my life - must be thoroughly competent at every aspect of life to be worthwhile - catastrophe when things aren't how i want them to be - should be very concerned with possible danger |
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New-Wave Cognitive Explanation |
- intolerance of uncertainty theory: certain people can't handle knowing bad things could happen, no matter how unlikely they are to happen - treatment: help patient realize how much worry impact has on their life, help them accept it - mindfulness-based cognitive therapy |
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Panic Disorder |
- most commonly treated anxiety disorder - prevalence: 2.8%; prevalence of panic attacks: 11.2% - onset: 15-35 - biggest biological component of all anxiety disorders - panic attacks cannot be diagnosed on their own |
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Theory of Panic Disorder |
- high genetic vulnerability - abnormal transmitter systems for norepinephrine, serotonin, and GABA - cognitive vulnerability: irrational appraisal of events - genetic vulnerability does not equal cognitive vulnerability - person is hyperaware of bodily sensations; misinterprets and catastrophizes them - treatment: help patients learn to reinterpret bodily sensations and decatastrophize - cognitive therapy works in 80% of cases |
